Checklist for a Complete Application

A Complete Application

We will require ALL of the following from you for a complete application.  Please have your complete application to us at least eight (8) weeks prior to your event. While we will accept applications closer to the event date (fees increase as we get closer to that date), we will not accredit two weeks prior to an event.

Also, please note that if family physicians are part of your participant group, Dr. Michael Fleming [michael.fleming@dal.ca] must be a corresponding member of your planning committee.  

  • FP = Family physicians only
  • SP = Specialist only
  • BOTH = Family physicians and specialists at the same event
  • ALL = alll of the above  

ALL

Completed and signed/dated accreditation application.  

ALL

Budget for event (if no budget, a statement to that effect) - NOTE: there will be an accreditation cost to be paid. Please also include any cost to participants or a statement that there is no such cost.)

ALL

Objectives for the event/program (can be indicated on page 3 of application).  These should include some non-medical expert CanMEDS competencies and a needs assessment. Should be a minimum of three.  (Sometimes a program has overarching objectives as well as specific objectives for each part.  We require all objectives be submitted.)

ALL

Draft agenda/program giving timing for all events, names of speakers and titles

Note:  CPD logo should appear, draft CPD credit statement should appear (this is available at the end of the application form); NO logos from sponsors (and nothing that mimics the sponsors’ logos).

FP or BOTH

Planning committee form – family physician (for all family physicians on the planning committee; if FPs are involved – Dr. Fleming must also be a corresponding member of the planning committee)

SP or BOTH

Planning committee form – specialists (for all specialists on the planning committee)

ALL

Conflict of interest forms (signed and filled in) from all members of Planning Committee except for the administrative people involved [Please return only the last two pages – first two are information only]

SP

Primary Sponsorship form  – signed and dated by Department Head

FP or BOTH

Co-Sponsorship form – signed and dated by Department Head

SP

Signed Approval Agreement  – signed and dated by planning committee chair

ALL

Declaration of Financial Sponsorship - signed by planning committee chair; please indicate what type of sponroship (see the initials below the textbox) and, if possible the actual amount of funding.

ALL

Copy of evaluation form – bias question MUST be present (please include space for a response if the answer to the bias question is "yes".)

ALL

National Standard acceptance – signed and dated by planning committee chair

ALL

Information on communication with speakers/presenters to fulfill criterion #5 in the application. (Please send a copy of your letter/e-mail correspondence)

Sect 3 only

For Royal College Specialists only. All of the above as for specialists PLUS an appropriate Section 3 application completed and signed.    

All of the above are required for a complete application to go forward for accreditation.

 

Each application form has a checklist near the end listing all the materials required for accreditation.  If items form that list are missing from the application package, we will follow up with you to get them.   

 

The COI forms for speakers/presenters can come after the accreditation letter is issued but are required PRIOR to the event. Our preference: include them as part of the application package.

Conflict of interest forms (signed and filled in) from all speakers and presenters (return only the last two pages – first two are information only]